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Antibiotics in Endodontics
 

Antibiotics in Endodontics

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The use of antibiotics in Endodontics

The use of antibiotics in Endodontics

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Antibiotics in Endodontics Antibiotics in Endodontics Presentation Transcript

  • Lecturer of Endodontics
    Al-Azhar University
    Ashraf
    Refai
    BDS MSc DD HMD
    ashraf_refai@hotmail.com
    AshrafSamirRefai
    www.arefai.edublogs.orgwww.idclinics.com
    +20101434323
  • Antibiotics in Endodontics
    AMDA (Arab Microdentistry Association)
    Advanced Endodontic
    Training Crouse
    30/11/2010
  • What Do We Know About Antibiotics??
    One of Greatest Medical Advances
    1935 Sulfanilamide & Penicillin
    The Single Most Abused Drug in Medicine
  • Myths About Antibiotics…
    Myth #1:
    Antibiotics Cure Patients
  • Myths About Antibiotics…
    Myth #2:
    Antibiotics Are Substitutes for Surgical Drainage
  • Myths About Antibiotics…
    Myth #3:
    60% of Infections Resolve
    by Host Defesnses
    The Most Important Decision is Which Antibiotic to Use
  • Myths About Antibiotics…
    Myth #4:
    Culture & Sensitivity Testing Are Required
  • Myths About Antibiotics…
    Myth #5:
    Tetracyclinesvs Beta Lactams
    Antibiotics Increase the Hosts Defense
  • Myths About Antibiotics…
    Myth #6:
    ADRs Microbial Resistance
    Expensive Antagonistic Effects
    Multiple Antibiotics Are Superior to Single Antibiotics
  • Myths About Antibiotics…
    Myth #7:
    Antibiotics Prophylaxis is Usually Effective
  • Myths About Antibiotics…
    Myth #8:
    Drug Resistant Bacteria
    Antibiotics are Effective Against Chronic Infections
  • Myths About Antibiotics…
    Myth #9:
    Prolonged Antibiotics Kill Resistant Infections
    Prolonged Antibiotics are Necessary to Prevent Rebound Infections (Remove the Cause)
    What Works for One Specialty Should not be Extrapolated to Another (2-7 Day Infections)
    Infections Require a Complete Course
  • Nosocomial Infections“Hospital BornInfections”
  • 5 Million Treated for Infections / Year3 Million Come in With One2 Million Get One at the Hospital
  • 5-6% of Patients in HospitalsGet a Nosocomial Infection6-8% Mortality Rate
  • 45-65% of Antibiotic Prescriptions are Inappropriate
  • What About inEgypt???
    3rd World Countries are a Major Source of Resistant Infections
  • Some Reasons Why Antibiotic Therapy Fails…
    Inappropriate Choice of Antibiotics
    Too Low Blood Concentration (Improper Dosing)
    Poor Penetration (Abscess)
    Limited Vascularity & High Acidity in the Affected Area
  • Some Reasons Why Antibiotic Therapy Fails…
    Antibiotic Antagonism (Multiple Antibiotics)
    Resistant Organisms
    Failure to Take Antibiotics (Patients Fault)
    Failure to Eradicate Infection
  • The Bacterial Mix…
    Initially Pulpal Infections
    are Mixed in Nature
    After Oxygen Depletion
    Facultative & Anaerobic
    Bacteria Predominate
  • When to Use Antibiotics???
    When there is a Reasonable Chance that
    the Infection may Spread Beyond the
    Periapex
  • Type of Antibiotics…
    Bactericidal
    (Fast Killing)
    Bacteriostatic
    (Slow Killing)
  • Penicillins
    Incorporates Beta-Lactam in Structure
    Bactericidal
    Short Half Life (Regular Doses)
    Accumulates in the Kidney
    Least Toxic Antibiotic
  • Cephalosporins
    Similar to Penicillins in Chemical Structure
    Also Incorporates Beta-Lactam in Structure
    Bactericidal
    Wide Spectrum
    1st , 2nd, 3rd,4th & 5th Generations
  • Considerations When Using Pennicilin & Cephalosporins
    Severe Allergic Reactions are Rare with these Groups
    If you are Allergic to One then you Could be Allergic to the Other
  • Considerations When Using Pennicilin & Cephalosporins
    Ressistance to this Group May Happen
    Beta-Lactamase Enzyme Neutralizes them
    Some Antibiotics Incorporate Clauvanic Acid which Makes it Resistant to the Enzyme
  • Metronidazole
    Bactericidal
    Mainly Affects Only Anearobic Bacteria
    Used in Combination with Other Antibiotics like (Augmentin)
    Causes Stomach Upset
    Darkened Urine
  • Macrolides (Erythromycin)
    Bacteriostatic
    Kills Same Range of Bacteria Like Penicillin
    Drug of Choice with Penicillin Allergy
    Has Serious Drug Interactions with Certain Antihistaminic & Bronchodialators
  • Clindamycin
    Bacteriostatic
    Wide Spectrum of Action
    Can Cause Pseudomembranous Colitis
    Over Growth of Clostridium difficile
    Penetrates well into Abscesses
  • Tetracycline (Doxycycline)
    Bacteriostatic
    Kills the Broadest Spectrum of Bacteria
    Excellent for Endo-Perio Lesions
    Not to be Given to Children, Pregnant or Lactating Women
    May Causes Photosensitivity
  • Antibiotic Prophylaxis
    The Purpose
    To Prevent Clinical Infection by Helping Destroy Small
    Numbers of Bacteria Present Before or Introduced
    During Treatment
  • Viridans Streptococcus
    Alpha Hemolytic
    Stores Energy by Forming Intra & Extra Cellular Polysaccharides(Sticky Vegetation)
    Colonies Form and Trap Fibrin & Blood Cells
  • When to Use Prophylaxis???
    Lets Look at the Handouts!!
  • Review
    Myths Surrounding Antibiotics
    Some Stastics Around the Abuse of Antibiotics
    Nosocomial Infections
    Bactericidal vsBacteriostatic
    The Different Types of Antibiotics
    When to use Antibiotic Prophylaxis